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Fuel metabolism during pregnancy
C J Homko1, E Sivan, E A Reece
1Department of Obstetrics and Gynecology and Reproductive Sciences, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
Seminars in Reproductive Endocrinology
|October 21, 1999
Summary
Pregnancy alters carbohydrate and fat metabolism, increasing insulin resistance in late gestation to support fetal growth. Women with gestational diabetes show similar or greater insulin resistance and reduced insulin secretion.
Area of Science:
- Reproductive biology
- Metabolic disorders
- Endocrinology
Background:
- Pregnancy involves dynamic metabolic adaptations in carbohydrate and fat utilization.
- Gestational diabetes mellitus (GDM) presents unique challenges to maternal metabolic regulation.
Purpose of the Study:
- To review recent findings on fuel metabolism during pregnancy.
- To compare metabolic changes in healthy pregnancies versus those with GDM.
Main Methods:
- Review of recent investigations using stable isotopes and insulin clamps.
- Analysis of hormonal and metabolic data in pregnant women.
Main Results:
- Early pregnancy shows enhanced insulin sensitivity and normal glucose tolerance.
- Late pregnancy is marked by increased insulin resistance, favoring fetal glucose supply.
- Maternal lipid utilization increases in late pregnancy, sparing carbohydrates for the fetus.
- Women with GDM exhibit comparable or increased insulin resistance and diminished insulin secretion.
Conclusions:
- Physiological insulin resistance in late pregnancy ensures adequate fetal nutrition.
- Gestational diabetes involves impaired insulin action and secretion, impacting maternal metabolism.